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Sound waves being used to heat-treat cancer pain

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Researchers investigate if next-generation ultrasound can burn away cancer pain

A pioneering clinical trial is testing whether focusing high-frequency sound waves onto the surface of bone where cancer has spread can burn away the source of pain.

trial patient
The focused ultrasound trial patient after her procedure to reduce pain from bone metastases.

The cutting-edge technique focuses ultrasound beams to produce heat – just as a magnifying glass can with the sun’s rays.

Researchers at The Institute of Cancer Research, London, and The Royal Marsden NHS Foundation Trust are ing whether ultrasound therapy can relieve pain in patients whose cancers have spread to the bone.

The first five patients have already been treated in the clinical trial, with encouraging reductions in the pain they were experiencing from bone tumours.

The technique, known as high-intensity focused ultrasound (HIFU), concentrates ultrasound energy precisely on a target in the body to thermally destroy tissue. The technology is coupled with magnetic resonance imaging (MRI) guidance to identify, target and track treatment in real time. The treatment produces heat to destroy the nerve tissue in the bone around the tumour causing the pain, while leaving adjacent areas unharmed.

Ultrasound has traditionally been used as a way of imaging the body but, used at higher power, researchers believe it offers promise as an exciting new way of treating cancer.

Patients whose cancers have metastasised to the bone can experience intense bone pain, which can severely reduce their quality of life. HIFU could provide a non-invasive way of controlling pain for these patients where radiotherapy is no longer an option, or where other treatments have been unable to control the disease.

If this HIFU study proves successful for pain control, it could lead to further studies at ICR and the Royal Marsden to thermally destroy local tumours at an earlier stage of the disease, possibly helping to extend life.

Royal Marsden patient Moira Rogers was the first patient to go on the clinical trial. She said: “Being on this trial has meant a great deal to me. It has helped get the pain I was in under control and given me my quality of life back. Trials like these are extremely important and I am so glad I have been given the opportunity by my doctors at The Royal Marsden to be part of this ground breaking study.”

Study co-leader Professor Gail ter Haar, Professor of Therapeutic Ultrasound at The Institute of Cancer Research, London, said: “Focused ultrasound is an exciting potential cancer treatment because of its ability to target tumours very precisely. The point onto which the ultrasound beam is focused gets very hot, but the surrounding tissue is left unharmed. It’s like using a magnifying glass in the sun to start a fire, where you need to form a sharp focal spot on the dry tinder.”

Study co-leader Professor Nandita deSouza, Professor of Translational Imaging at The Institute of Cancer Research, London, and Honorary Consultant at The Royal Marsden NHS Foundation Trust, said: “We’re still learning how best to use focused ultrasound, but we believe it has real potential for improving the quality of life of patients with advanced cancer. Cancers that have spread to the bone can cause intense pain, and further radiotherapy may not be an option. It is early days in our trial, but we hope ultrasound therapy will prove effective at reducing the pain caused by bone metastases, and offer the chance for patients to live the final stages of their lives much more comfortably.”

The trial is part of a wider initiative between the ICR, The Royal Marsden, the Focused Ultrasound Foundation and Philips, the developer of the HIFU system. This collaboration is creating a state-of-the-art resource for clinicians and scientists to establish global standards for focused ultrasound and accelerate development of the technology to treat cancers.

Neal F. Kassell, M.D., Founder and Chairman of the Focused Ultrasound Foundation said “We are delighted to work with the clinical and technical teams at The Royal Marsden and ICR. We look forward to this collaboration advancing the science and helping to develop the best clinical practices needed for widespread adoption to ultimately help extend the lives of patients with a range of cancers.”

“MR imaging is emerging in oncology applications, because of its excellent real-time 3D visualization of both soft tissue anatomy and physiological processes”, said Christopher Busch, General Manager MR Therapy at Philips. “Combining focused ultrasound thermal therapies with real-time MR imaging and monitoring is a powerful concept that has the potential to become a new precision treatment tool in oncology.”

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The Institute of Cancer Research
The Institute of Cancer Research, London, is one of the world’s most influential cancer research institutes.

Scientists and clinicians at The Institute of Cancer Research (ICR) are working every day to make a real impact on cancer patients’ lives. Through its unique partnership with The Royal Marsden Hospital and ‘bench-to-bedside’ approach, the ICR is able to create and deliver results in a way that other institutions cannot. Together the two organisations are rated in the top four cancer centres globally.

The ICR has an outstanding record of achievement dating back more than 100 years. It provided the first convincing evidence that DNA damage is the basic cause of cancer, laying the foundation for the now universally accepted idea that cancer is a genetic disease. Today it leads the world at isolating cancer-related genes and discovering new targeted drugs for personalised cancer treatment.

As a college of the University of London, the ICR provides postgraduate higher education of international distinction. It has charitable status and relies on support from partner organisations, charities and the general public.

The ICR’s mission is to make the discoveries that defeat cancer. For more information visit http://www.icr.ac.uk

The Royal Marsden NHS Foundation Trust
The Royal Marsden opened its doors in 1851 as the world’s first hospital dedicated to cancer diagnosis, treatment, research and education.

Today, together with its academic partner, The Institute of Cancer Research (ICR), it is the largest and most comprehensive cancer centre in Europe treating over 50,000 NHS and private patients every year. It is a centre of excellence with an international reputation for groundbreaking research and pioneering the very la in cancer treatments and technologies.

The Royal Marsden, with the ICR, is the only National Institute for Health Research Biomedical Research Centre for Cancer. First awarded the status in 2006, it was re-awarded in 2011. A total of £62 million is being provided over five years, to support pioneering research work, and is being shared out over eight different cancer themes.

The Royal Marsden also provides community services in the London boroughs of Sutton and Merton and in June 2010, along with the ICR, the Trust launched a new academic partnership with Mount Vernon Cancer Centre in Middlesex.

Since 2004, the hospital’s charity, The Royal Marsden Cancer Charity, has helped raise over £100 million to build theatres, diagnostic centres, and drug development units.

Prince William became President of The Royal Marsden in 2007, following a long royal connection with the hospital.

The Focused Ultrasound Foundation
The Focused Ultrasound Foundation was created to improve the lives of millions of people worldwide by accelerating the development and adoption of focused ultrasound therapies. The Foundation works to clear the path to global adoption by coordinating and funding research and educational activities, creating partnerships and fostering collaboration among stakeholders, and building awareness of the technology among patients and professionals. The Foundation is dedicated to ensuring that focused ultrasound finds its place as a mainstream therapy for a range of neurological disorders, including Parkinson’s disease, epilepsy and stroke as well as uterine fibroids, cancer and other life-threatening conditions within years, not decades. Since its establishment in 2006, the Foundation has become the largest non-governmental source of funding for focused ultrasound research. More information about the Charlottesville, Virginia based Foundation can be found at www.fusfoundation.org.

About Royal Philips
Royal Philips (NYSE: PHG, AEX: PHIA) is a diversified health and well-being company, focused on improving people’s lives through meaningful innovation in the areas of Healthcare, Consumer Lifestyle and Lighting. Headquartered in the Netherlands, Philips posted 2013 sales of EUR 23.3 billion and employs approximately 115,000 employees with sales and services in more than 100 countries. The company is a leader in cardiac care, acute care and home healthcare, energy efficient lighting solutions and new lighting applications, as well as male shaving and grooming and oral healthcare. News from Philips is located at www.philips.com/newscenter.